Factors determining gender ratio in the Maltese population

Introduction: The Male/Female ratio at birth has been described to favour the male conceptus, a situation that persists throughout most of childhood and into the reproductive phase of life. The reasons behind this preferential male-favouring remain elusive. Methodology: The various relevant obstetric and population national registers kept by the Department of Health information and the National Statistics Office of the Maltese Islands were reviewed to elucidate the age-related M/F ratios differences in the population starting with the third trimester of the antenatal period. In addition, third trimester M/F ratios in women with specific metabolic-related disorders were assessed and compared to the on-affected individuals. The role of foetal congenital malformations was also investigated. Results: It would appear that the M/F ratio starts favouring the male conceptus as early as the third trimester of the antenatal period. It remains favoured right through the reproductive age reaching par after the age of 45 years when it shifts to favour the female. This relationship was significantly altered during the 1930s as a result of the emigration patters prevalent during that period. The results further show that the maternal nutritional and biochemical milieu may influence the M/F ratio at the beginning of the third trimester with women suffering from adiposity, diabetes and thyroid disease having higher M/R ratios. In spite of this preference to the male conceptus, malts have a higher mortality throughout life with mortality rates being higher for males from the third trimester up to the age of 75 years. On the other hand, female foetuses with malformations appear to have a higher mortality during intrauterine life than corresponding male foetuses. Conclusion: The M/F ratio appears to favour the male conceptus during antenatal life and is definitely evident by the beginning of the third trimester of pregnancy, the selection mechanism possibly being a greater predisposition of female foetal loss in the presence of malformations. These biological observations may present advantages within the breath of human reproductive ecology, ensuring a healthy reproductive female individual who has the option of choosing her mate from a competing male community.peer-reviewe